Utilizing head motion measurements integrated with clinical outcomes to inform post-concussion return to play protocols in gymnastics

利用头部运动测量与临床结果相结合，为体操中脑震荡后恢复比赛方案提供信息

• 批准号: 10433034
• 负责人: Jillian Elizabeth Urban
• 金额: $ 22.85万
• 依托单位: WAKE FOREST UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-02-14 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10433034
• 关键词: Acceleration; Acute; Address; Affect; Age; American; Area; Assessment tool; Back; Biomechanics; Body Regions; Brain Concussion; Caring; Clinical; Clinical Assessment Tool; Clinical assessments; Cognition; Communities; Community Medicine; Complex; Craniocerebral Trauma; Data; Development; Discipline; Elements; Emergency department visit; Enrollment; Environment; Equilibrium; Evaluation; Event; Exposure to; Female; Frequencies; Goals; Gymnastics; Head; Head Movements; Height; Hospitals; Impairment; Injury; Investigation; Knowledge; Lead; Manufactured Baseball; Measurement; Measures; Memory; Modeling; Modification; Monitor; Motion; Musculoskeletal Equilibrium; Neurocognitive; Outcome; Participant; Play; Positioning Attribute; Protocols documentation; Recommendation; Recovery; Recreation; Research; Research Project Grants; Rotation; Safety; Series; Severities; Sports; Sports Medicine; Surface; Symptoms; Traumatic Brain Injury; United States; Weight; Youth; base; behavior measurement; college; design; experience; falls; head impact; high risk; high school; improved; instrument; kinematics; male; motion sensor; motor impairment; motor symptom; novel; oculomotor; research study; sex; skills

Project Summary/Abstract Gymnastics is a leading cause of head injury among sports- and recreation-related activities and is the second most common cause of emergency room visits for non-fatal traumatic brain injury among non-contact sports. As a sport, gymnastics is composed of six disciplines that utilize various skills to showcase balance, power, and artistry. The physical demands of the sport often lead to a variety of injuries, including concussion. Concussions in gymnastics commonly occur from falls and missed landings, but gymnasts are also exposed to direct (contact) and inertial (non-contact) accelerations of the head while performing complex skills that are generally not associated with concussion but may affect recovery following concussion. Additionally, athletes may experience impairments to memory, concentration, and vestibular/ocular-motor symptoms following concussion, but effects from repetitive rotational head movements, such as those experienced by gymnasts, are not well-understood. With ~ 5 million Americans participating in gymnastics-related activities, there is a critical need to understand the head accelerations experienced by gymnasts and their relationship to concussion-related clinical outcomes to inform safety recommendations, including post-concussion return to play protocols, in the sport. The objective of this study is to characterize kinematics (i.e., accelerations, velocity) of the head across skills performed in artistic gymnastics and their relationship to concussion-related clinical outcomes and evaluate the effect of safety modifications on reducing kinematic loads experienced by gymnasts. In Aim 1, 16 beginner-level (8 male, 8 female) and 16 advanced-level (8 male, 8 female) artistic gymnasts (ages 11-15) will be fitted with mouthpiece- based head motion sensors. Biomechanical data will be collected and quantified during all practices to determine the frequency, magnitude, and duration of head accelerations experienced during normal participation of the sport. In Aim 2, we will engage stakeholders in the gymnastics and sports medicine communities to identify and evaluate skill-specific safety modifications to reduce head kinematics in gymnastics. Enrolled gymnasts will complete a series of skills with two progressive safety modifications; the effect of safety modifications on reducing head accelerations will be evaluated. In Aim 3, the relationship between exposure to head accelerations during normal participation of gymnastics and concussion-related clinical outcomes will be evaluated. Changes in pre- to post-study cognition and postural control and acute changes in concussion-related symptoms will be monitored using validated clinical assessment tools and evaluated with respect to head acceleration measuring during the study. This R21 exploratory/developmental research study seeks to ultimately change the paradigm of concussion safety in gymnastics and will result in key data to support a large-scale study to develop and evaluate a biomechanically-informed return to play protocol for gymnastics. This approach will provide a framework that may be expanded to other disciplines of gymnastics and acrobatic sports to improve the safety of over 5 million athletes participating in acrobatic activities.

项目摘要/摘要 在与运动和娱乐相关的活动中，体操是导致头部损伤的主要原因，排在第二位 在非接触性运动中，非致命性脑损伤急诊室就诊的最常见原因。AS 作为一项运动，体操由六个项目组成，这些项目利用不同的技能来展示平衡、力量和 艺术性。这项运动的身体需求经常会导致各种伤害，包括脑震荡。脑震荡 在体操比赛中，摔倒和落地失误是常见的，但体操运动员也有直接接触的危险 头部的惯性(非接触)加速，同时执行复杂的技能 与脑震荡有关，但可能会影响脑震荡后的恢复。此外，运动员可能会体验到 脑震荡后记忆力、注意力和前庭/眼球运动症状的损害，但影响 从重复的头部旋转动作，如体操运动员所经历的，还没有被很好地理解。 约有500万美国人参加与体操相关的活动，迫切需要了解 体操运动员的头部加速及其与脑震荡相关临床结果的关系 告知运动中的安全建议，包括脑震荡后恢复比赛方案。目标是 这项研究的目的是描述头部在不同技能之间的运动学特征(即加速度、速度) 艺术体操及其与脑震荡相关临床结局的关系及安全性评价 降低体操运动员运动负荷的改进。在目标1中，16名初学者(8名男性，8名 (女)和16名高水平(8男，8女)艺术体操运动员(年龄11-15岁)将配备口罩- 基于头部运动传感器。生物力学数据将在所有练习中收集和量化，以确定 头部加速的频率、大小和持续时间 运动。在目标2中，我们将与体操和运动医学社区的利益相关者合作，以确定和 评估特定技能的安全修改，以减少体操中的头部运动学。入选的体操运动员将 通过两次渐进的安全改进来完成一系列技能；安全改进对减少 将对头部加速进行评估。在目标3中，暴露于头部加速之间的关系 将对正常参与体操和脑震荡相关的临床结果进行评估。Pre-Pre的变化 学习后的认知和姿势控制以及脑震荡相关症状的急性变化将 使用有效的临床评估工具进行监测，并根据头部加速测量进行评估 在研究过程中。这项R21探索性/发展性研究试图最终改变范式 并将产生关键数据支持一项大规模研究，以开发和 评估体操的生物力学信息返回比赛方案。这种方法将提供一种 框架，可扩展到体操和杂技运动的其他项目，以提高安全性 500多万名参加杂技活动的运动员。